The SPAEN Sarcoma Policy Paper “Sarcoma Patient Pathway Analysis and Recommendations for Service Development” was developed by SPAEN’s honorary president Roger Wilson, UK, co-chairs Markus Wartenberg and Estelle Lecointe-Artzner. It serves as a basic document for other European initiatives and provides sarcoma patient views on matters such as expert treatment centres, reference centres, rare cancer protocols, etc. The objective with this paper is to give a clear statement of what SPAEN expects sarcoma treatment to look like, how SPAEN expects service structures to develop to respond to patient needs, and how national and international referral practice should evolve.